for eMaxHealthThere are many kinds of medicines that treat depression:
SSRI's
One group of medicines is called the SSRI's (serotonin re-uptake inhibitors). SSRI's act to increase the amount of serotonin in the brain. Serotonin is thought to control appetite, sleep and mood. Abnormally low levels of serotonin disturb these bodily functions.
Prozac , Paxil , Zoloft and CelexaTM are the best known medicines in the SSRI class. These agents appear safe in pregnancy and during nursing. They do not increase the risk of congenital anomalies, difficulty with delivery, or the infant's development.
Tricyclic Antidepressants
The tricyclic antidepressants are an older class of medicines that work on many chemical systems in the brain including the serotonergic, adrenergic and cholinergic systems. Together these chemicals impact mood, and when they become unbalanced mood, sleep, appetite, energy, motivation and pleasure all suffer. These include medicines like Tofranil (imipranine), Norpramin (desipranine) and Pamelor (nortryptiline).
These medications are considered safe in pregnancy and lactation. They may cause dry mouth, agitation or sleepiness, difficulty with urination, blurred vision, and irregular heartbeat. Your health care provider may wish to draw blood levels to make sure that there is adequate medication to treat your depression.
Other Antidepressants
Effexor (venlafaxine) works on both the serotonin and adrenergic system and is a useful medication especially if the SSRI's alone fail to treat a mood problem. It has not been well studied in pregnancy however. Like the SSRI's it is usually well tolerated and may be useful for both depression and anxiety problems.
Serzone (nefazodone) also impacts many chemical systems in the brain. It is a good choice for patients with anxiety and insomnia as a prominent part of their mood problem. It has not been studied well in pregnancy.
Wellbutrin (bupropion) is an atypical antidepressant and acts on the dopamine system in the brain. As such, it may help individuals who have poor motivation, low energy and drive as a prominent part of their depression. It is a good choice for people who experience sexual side-effects due to antidepressant medication.
Herbal and Complementary Medicines
Several herbal remedies have been investigated in Europe and may help depression, though U.S. studies to date are not conclusive. A large multi-center trial sponsored by the National Institute of Health is underway.
St. John's Wort (Hypericum Perforatum) has been studied in Germany and appears to be helpful for mild to moderate depression. This agent may interact with SSRI's and should not be combined with them.
Sam-E (S-adenosyl methionine) may assist other antidepressant agents by increasing the rate of reactions that are necessary to build levels of brain neurochemicals. It has not been well studied as an agent that acts alone however.
Omega 3 fatty acids may be useful in combating depression in patients with bipolar illness, and are beginning to be used in conjunction with traditional antidepressants, but like the other agents are not yet studied well in the U.S.A.
Side Effects of Antidepressants
Side effects may occur when antidepressants are prescribed. Much of the time these side effects become less severe as time goes on, and may be minimized by changing the time of day that they are administered. Common side effects include: jitteriness, sleep disruption, sleepiness during the day, weight gain, sexual side effects, dry mouth, and tremulousness.
It is important to speak to your health care provider if you are experiencing side effects so that your dosage can be adjusted, or another medication added to minimize side effects. Often times the side effects can be minimized.
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The source of this article is http://www.med.umich.edu
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